Tobacco and HPV leading causes of oral cancers in India, says doctors of Head and Neck Cancer Institute of India, Mumbai

Mumbai: Not only does India continue to shoulder one of the world’s heaviest oral cancer burdens, but doctors also warn that most patients still reach hospital at a very advanced stage of the disease.

Tobacco consumption remains the main cause of the disease, but there is a growing number of younger patients being diagnosed with human papillomavirus-linked cancers, particularly those associated with HPV-16 infection, according to doctors of Mazgaon-based Head & Neck Cancer Institute of India (HNCII). May 31 is observed as World No Tobacco Day.

Sharing an analysis of 5,135 cancer surgeries conducted in the hospital between Aug 2023 and Dec 2025, HNCII's doctors said that nearly half of all head-and-neck cancer cases were linked to tobacco use. More than 60% of the surgical burden came from Maharashtra and Uttar Pradesh, both states with high tobacco consumption.

According to Global Cancer Observatory (GLOBOCAN) estimates, approximately 200,000 (17%) head-and-neck cancers are diagnosed annually.

"The data emanating from the 36 population-based registries and six hospital-based cancer registries in India indicate that, irrespective of the geographical location in India, oral cancers are leading cancers in all the registries as reported by National Centre for Disease Informatics and Research (NCDIR)," according to a research paper by doctors from Tata Memorial Centre, published in The Indian Journal of Medical Sciences in 2003. Tata Memorial Hospital (TMH) registers over 50,000 cancers annually, of which 35% are head-and-neck cancers.

The HNCII data showed that Maharashtra accounted for 1,497 head-and-neck cancer surgeries among 1,822 patients, while Uttar Pradesh recorded 1,619 surgeries among 1,693 patients.

Delayed diagnosis remains a major concern. Only 19% of patients were diagnosed in the early stages, while over one-fifth had already progressed to Stage III or IV disease by the time they sought treatment.

"The real concern is not just how many patients we are seeing, but how late they are coming to us," said Dr Sultan Pradhan, founder and senior surgical oncologist at HNCII. "These are cancers that are largely preventable, yet tobacco use continues to drive a significant proportion of cases."

Experts say tobacco consumption — including gutka, khaini and smoking products — continues to be the single biggest risk factor. For a majority of patients who come late for treatment, the window for simpler, more effective treatment is already missed, increasing both treatment complexity and risk of poor outcomes.

Cancer specialists said the findings underline the urgent need for stricter tobacco-control measures, wider screening programmes and greater public awareness to curb India's rising oral cancer burden.